Weight Management: Obesity to Diabetes

Franz, Marion J.

doi:10.2337/ds17-0011

Cited by 25 publications

(16 citation statements)

References 18 publications

(10 reference statements)

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“…Furthermore, there is reasonable evidence that insulin may cause some weight gain rather than loss [23][24][25][26][27]. Our findings for persistently high BMI values support this view, demonstrating substantial weight gain in all evaluated subgroups after one year of treatment with insulin, even though treatment guidelines suggest weight reduction of 5-10% to improve blood glucose levels in the early stages of diabetes when the insulin-secretion capacity is still relatively well preserved [28][29][30]. Current data available on this topic could show that a combination of insulin and metformin is associated with better glycemic control, reduced daily insulin dose, less hypoglycemia, and less weight gain compared to insulin monotherapy [31][32][33].…”

Section: Discussionsupporting

confidence: 75%

Real-world clinical outcomes and costs in type 2 diabetes mellitus patients after initiation of insulin therapy: A German claims data analysis

Gabler

Picker

Geier

et al. 2021

Diabetes Research and Clinical Practice

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Background: This study describes real-world treatment-related outcomes and healthcare costs of German type 2 diabetes mellitus (T2D) patients who initiated insulin therapy. Methods: This retrospective analysis includes German claims data from 01/01/2012 until 31/12/2016. Identification of eligible patients took place between 01/01/2013 and 31/12/2015, allowing for at least 1 year of follow-up. Clinical outcomes, such as HbA1c values and body mass index, were observed in a subpopulation participating in a Disease Management Program. Healthcare expenditures were evaluated for the first year of therapy. Results: Overall, 27,340 insulin starters with T2D were observed (mean age: 72.2 years, female: 51.4%). Treatment-related outcomes were evaluated in a subsample of 12,034 patients. Patients who started insulin combined with other antidiabetic drugs (ADs) achieved their HbA1c goals more frequently than patients on insulin monotherapy (+10.7 percentage points [pp] vs. +21.1 pp for insulin plus metformin). All-cause costs were by far highest among patients with insulin monotherapy (€ 12,283 per patient-year) compared with patients receiving a combined AD regimen (€ 9,947-10,509 per patient-year). Conclusions: Changes in HbA1c values were not in favor of insulin monotherapy, compared to regimens including other ADs. It was also associated with higher costs, suggesting that insulin alone is a suboptimal treatment.

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Section: Discussionsupporting

confidence: 75%

Real-world clinical outcomes and costs in type 2 diabetes mellitus patients after initiation of insulin therapy: A German claims data analysis

Gabler

Picker

Geier

et al. 2021

Diabetes Research and Clinical Practice

View full text Add to dashboard Cite

show abstract

“…The primary outcome was mean weight loss from baseline at 6 months post-intervention, with the aim of achieving clinically meaningful weight loss of >5% ( 27 ). Body weight after an overnight fast was measured in the clinic by research staff using a standard digital weighing scale (Omron HN-289, Japan), with participants lightly clothed and without shoes.…”

Section: Methodsmentioning

confidence: 99%

A Smartphone App-Based Lifestyle Change Program for Prediabetes (D'LITE Study) in a Multiethnic Asian Population: A Randomized Controlled Trial

et al. 2022

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IntroductionLandmark studies have established that lifestyle interventions focused on weight loss, diet modification and physical activity can prevent diabetes progression. However, the effectiveness of mobile health application among Asians with prediabetes remains largely unexamined. We aimed to assess whether a smartphone app-based lifestyle intervention program would lead to weight loss, normoglycemia and improved metabolic indices in a multiethnic Asian population with prediabetes.Research Design and MethodsThis multicentre prediabetes RCT is part of the Diabetes Lifestyle Intervention using Technology Empowerment (D'LITE) trial. Adults (n = 148) with prediabetes and BMI ≥ 23 kg/m2 were randomly allocated either to the intervention group (n = 72) empowered by self-monitoring features of the Nutritionist Buddy Diabetes app with in-app dietitian coaching for 6 months, or the control group (n = 76) receiving standard diet counseling at baseline. Primary outcome was defined as change in body weight at 6 months, while secondary outcomes included glycemic control and other metabolic indices analyzed using Generalized Linear Mixed Model analysis with intention-to-treat approach.ResultsIntervention group achieved a significantly greater weight loss of 4.2 vs. 1.3 kg [mean difference of −3.1 kg (95% CI −4.5 to −1.7), p < 0.001], and a 4.3-fold increased likelihood of achieving ≥ 5% weight loss, as compared to the control group at 6 months. The likelihood of achieving normoglycemia (defined as HbA1c < 5.7%) was 2.1 times higher in intervention group than in the control group (p < 0.018). Changes to blood pressure, total and LDL cholesterol were not statistically significant.ConclusionAn app-based lifestyle program led to clinically significant weight loss and improved glycemia, and can potentially augment current standard care in the prevention of diabetes among an Asian multiethnic population.Clinical Trial Registrationanzctr.org.au, identifier: ACTRN12617001112358.

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“…It is also known that a BMI higher than 21 is associated with an increased risk of DM [ 52 ]. Therefore, the initial weight loss and exercise seem crucial in controlling DM [ 53 , 54 ], and clinical studies have demonstrated that combined lifestyle intervention and metformin-mediated weight loss significantly reduced the incidence of DM [ 55 , 56 ]. In addition to regular exercise, a very low energy diet is also effective in weight loss, glycemic control, and regulation of lipid metabolism among overweight T2DM patients [ 57 ].…”

Section: Treatment Strategies For Concomitant Liver Disease and Diabetesmentioning

confidence: 99%

Reenvisioning Traditional to Regenerative Therapeutic Advances in Managing Nonalcoholic Fatty Liver Disease in Diabetes Mellitus

Tsai

Dubey

et al. 2021

Journal of Diabetes Research

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Reports indicate the increasing prevalence of liver disorders in diabetes mellitus (DM) patients. Clinically, it has also been revealed that the existence of nonalcoholic fatty liver disease (NAFLD) enhances the incidence of type 2 diabetes mellitus (T2DM), while T2DM exacerbates NAFLD to extremely severe forms of steatohepatitis, cirrhosis, and hepatocellular carcinoma. This implies the coexistence and bidirectional nature of NAFLD and T2DM, which function synergistically to drive adverse consequences in clinical practice. For treatment of such comorbid state, though the existing practices such as lifestyle management, traditional Chinese medicines (TCM), and pharmaceuticals have offered somewhat relief, the debate continues about the optimal therapeutic impacts. Recent developments in the field of tissue engineering have led to a renewed interest in novel biomaterial alternatives such as stem cells. This might be attributable to their differentiation potential towards hepatic and pancreatic lineage. These cellular therapies could be further complemented by platelet-derived biomaterials, TCM formulations, or any specific drug. Based on these abovementioned approaches, we aimed to comprehensively analyze various preclinical and clinical studies from traditional to regenerative therapeutic approaches in managing concomitant NAFLD and T2DM.

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Weight Management: Obesity to Diabetes

Cited by 25 publications

References 18 publications

Real-world clinical outcomes and costs in type 2 diabetes mellitus patients after initiation of insulin therapy: A German claims data analysis

Real-world clinical outcomes and costs in type 2 diabetes mellitus patients after initiation of insulin therapy: A German claims data analysis

A Smartphone App-Based Lifestyle Change Program for Prediabetes (D'LITE Study) in a Multiethnic Asian Population: A Randomized Controlled Trial

Reenvisioning Traditional to Regenerative Therapeutic Advances in Managing Nonalcoholic Fatty Liver Disease in Diabetes Mellitus

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